David F. Tang-Wai, MDCM, FRCPC, Assistant Professor, Department of Medicine, University of Toronto; University Health Network Memory Clinic, University of Toronto, Toronto, ON.
Naida L. Graham, PhD, Research Associate, Department of Speech-Language Pathology, University of Toronto; University Health Network Memory Clinic, University of Toronto; Toronto Rehabilitation Institute, Toronto, ON.

Impairment in language is a common finding among individuals with dementia and can be a presenting symptom, particularly in Alzheimer’s dementia and primary progressive aphasia. Early recognition of language dysfunction can help with an accurate diagnosis, management, and prognosis. There are numerous established and validated language evaluation protocols. This article provides a simple means for the primary care physician to identify and evaluate language disorders in dementia, but it is not meant to replace established protocols.
Key words: aphasia, dementia, primary progressive aphasia, semantic dementia, Alzheimer’s disease.

Karl Farcnik, BSc, MD, FRCPC, Psychiatrist, Division of Geriatric Psychiatry, University of Toronto, Toronto, ON.
Michelle Persyko, Psy.D, C.Psych, University of Toronto, Toronto, ON.
C. Bassel, M.A., University of Toronto, Toronto, ON.

Introduction
Aphasia has been described as a disorder of verbal communication due to an acquired lesion (or lesions) of the central nervous system involving speech production and/or comprehension.¹ Aphasia does not involve deficits in global processes of communication, but only in its linguistic component, as evidenced by patients' ability to communicate through other means (e.g., complex nonverbal gestures).² Aphasia is an integral part of the clinical presentation in Alzheimer Disease (AD). It is also an important diagnostic feature of other neurological disorders, which may be distinctive or overlap with AD. Clinicians should have a conceptual understanding of the different forms of aphasia as well as the conditions with which they are associated. The authors will review the diagnosis, assessment and treatment of aphasia, in the context of AD, Primary Progressive Aphasia (PPA), Frontotemporal dementia (FTD) and stroke.

The major types of aphasia can be classified as either fluent or nonfluent.